This application is a continuation of International Application No. PCT/JP2015/081654 filed on Nov. 10, 2015, and claims priority to Japanese Patent Application No. 2014-261064 filed on Dec. 24, 2014, the entire content of both of which is incorporated herein by reference.
The present invention generally relates to a stent serving as a medical device.
A stent is a medical device used to treat various diseases caused by a stenosed or occluded lumen of a blood vessel. A stent is used for securing a cavity by widening the stenosed or occluded site. A stent is known in which a strut is formed in a helical shape along an axial direction, for example, as disclosed in Japanese Patent Application Publication No. 2009-522022.
A type of the stent in which the strut is formed in the helical shape in this way includes a balloon expandable stent which is not provided with a self-expandable function and which is expanded by a balloon, or a self-expandable stent which is expanded using a self-elastic deformation force.
The strut described above is formed in the helical shape along the axial direction. Accordingly, one end side is separated from the other end side (i.e., at the opposite end) of the strut along the axial direction. A stent having this configuration is less likely to maintain a shape particularly after the diameter of the stent expands. Consequently, in a case where the stent is deformed to reduce the diameter by itself while attempting to restore the original shape of the stent, it is difficult to restrain/control the deformation. That is, the stent formed in a helical shape along the axial direction as described above cannot sufficiently restrain a contraction force (diameter reduction force) generated due to the deformation with the diameter expansion, and it is difficult to decrease a recoil rate of the stent.
The stent discloses here addresses the above-described problem, and possesses a relatively lower recoil rate than the strut formed in the helical shape along the axial direction.
The stent disclosed in this application has a stent body that is formed into a cylindrical shape by a strut. The stent body includes a plurality of helical portions in which the strut is formed in a helical shape along an axial direction, and an annular portion that is disposed between the helical portions adjacent to each other in the axial direction. The annular portion of the strut is formed in an annular shape along the circumferential direction.
The annular portion in which one end side and the other end side (i.e., at the opposite end) are endlessly connected to each other is more likely to maintain its shape in a radial direction K than the helical portion described above in which one end side and the other end side are separated from each other. Therefore, after the stent body expands the diameter, the annular portion can restrain the helical portion from being deformed when the stent body attempts to reduce the diameter so as to restore the original shape. That is, the stent can restrain a contraction force (diameter reduction force) generated due to the deformation with the diameter expansion, and it is possible to considerably decrease a recoil rate.
Set forth below with reference to the accompanying drawings is a detailed description of embodiments of a stent representing examples of the inventive stent disclosed here. The following description does not limit the technical scope or the meaning of terms described in the scope of the appended claims. Dimensional proportions in the drawings are exaggerated and different from actual dimensional proportions for convenience of description. In all of the drawings, a stent is illustrated in a state where the stent is cut out from an original metal pipe when the stent is manufactured (i.e., a state before the stent is crimped on, for example, a delivery catheter).
As illustrated in
The stent body 110 integrally includes helical portions 111 (111M, 111N) and annular portions 112 (112P, 112Q, and 112R) as illustrated in
The annular portions 112P, 112Q, and 112R each possess the same shape, and a strut 112a is formed in an annular shape along the circumferential direction S. Specifically, the annular portion 112P, 112Q, and 112R are each formed in an annular shape along the circumferential direction S while alternately protruding and curving toward a proximal side 110b and a distal side 110d along the axial direction Z. In this manner, the annular portion 112P, 112Q, and 112R are configured to have an endless shape (i.e., the annular portions 112P, 112Q, 112R are non-helical, or in other words, the annular portions 112P, 112Q, 112R are endless loops without a beginning or ending point). The annular portion 112Q is disposed between helical portions 111M and 111N that are adjacent to each other along the axial direction Z. The annular portion 112Q is thus located in a central portion 110c of the stent body 110. An end point of the helical portions 111M and 111N is directly connected to the annular portion 112Q. The annular portion 112P is disposed adjacent to the helical portion 111M so that the annular portion 112P is located in the proximal portion 110a on the proximal side 110b of the stent body 110. An end point of the helical portion 111M is directly connected to the annular portion 112P. The annular portion 112R is disposed adjacent to the helical portion 111N so that the annular portion 112R is located in a distal portion 110e on the distal side 110d of the stent body 110. An end point of the helical portion 111N is directly connected to the annular portion 112R.
As shown by the schematic illustration in
As illustrated in
As illustrated in
The first engagement portion 63 has a first protruding portion 63a and a first housing portion 63b. The first protruding portion 63a is formed to protrude toward the second helical portion side from the curved portion 48. The first housing portion 63b is formed to be recessed in a concave shape between the first protruding portion 63a and the curved portion 48. The second engagement portion 66 similarly has a second protruding portion 66a formed to protrude toward the first helical portion side from the curved portion 48 and a second housing portion 66b formed to be recessed in a concave shape between the second protruding portion 66a and the curved portion 48.
The first protruding portion 63a included in the first engagement portion 63 is formed so that a shape of the distal portion is curved (i.e., the distal end of the first protruding portion 63a is curved as shown in
The respective protruding portions 63a and 66a can be arranged to form a gap g between the respective housing portions 63b and 66b. The respective protruding portions 63a and 66a can also be arranged to partially come into contact with the respective housing portions 63b and 66b. In addition, the respective engagement portions 63 and 66 can be arranged so that the engagement portions 63 and 66 partially or entirely overlap each other in a region along the circumferential direction S and/or the axial direction Z of the stent 100 as illustrated in
The connection member 71 covers a surface of the connection structure 61 and fills portions between the respective protruding portions 63a and 66a and the respective housing portions 63b and 66b. A configuration can be adopted in which a concave portion is formed or a through-hole penetrating both front and back surfaces is formed on the surface of the respective engagement portions 63 and 66. The connection member 71 may thus fill the concave portion or the through-hole. According to this configuration, it is possible to improve adhesion (i.e., the adhesive force) of the connection member 71 adhering to the connection structure 61.
Since the stent 100 includes the helical portion 111, the stent 100 is flexible. Therefore, the stent's ability to follow the deformation of the lumen (followability) is improved. The connection member 71 formed of the biodegradable material having a relatively strong physical property (i.e., the biodegradable material applies a relatively strong adhesion/boding force to connect the helical portions 111 to each other) is disposed in a portion connecting the helical portions 111 to each other. Accordingly, the stent body 110 can be provided with desirable rigidity. While satisfactory followability to follow the deformation of the lumen is ensured, an expansion holding force can be improved when the stent 100 is caused to indwell the lumen. The indwelling connection member 71 degrades after a predetermined period elapses so that the connecting force of the connection portion 60 is weakened. When this degradation occurs, flexibility of the stent 100 is further improved. Accordingly, the followability of the stent to follow the deformation of the lumen is further improved. Therefore, in an initial stage of the indwelling period, a desired expansion holding force is achieved, and after the predetermined period elapses from the indwelling and the connection member 71 degrades, improved flexibility is achieved. The stent 100 thus becomes relatively excellent in regard to invasiveness and a treatment effect. In addition, the annular portion 112P and the annular portion 112R (which are disposed in both end portions of the stent body 110) maintain a predetermined expansion holding force regardless of the degradation of the connection member 71. Therefore, it is possible to apply a sufficient expansion holding force to the lumen from both end portions of the stent body 110 even after the connection member 71 is degraded. Accordingly, it is possible to suitably prevent the stent 100 from being misaligned after the stent 100 indwells.
It is preferable to provide one or more connection portions 60 for each one of the helical portions 43 (one unit of the helical portion 111 in the circumferential direction). However, the number of connection portions 60 is not particularly limited. The structure of the connection portion 60, and the form of the connection structure 61 and the connection member 71 which are included in the connection portion 60, is not limited to the above-described configurations. The structure and the form can be appropriately changed. For example, a shape of the respective engagement portions 63 and 66 included in the connection structure 61 can be different than the shapes discussed above as long as the mechanical connection can be created. The connection portion 60 can be configured to change the connecting force without interposing the connection member 71 therebetween. For example, it is possible to employ a fragile portion (which is more likely to be broken than other portions) in a portion of the connection structure 61. The fragile portion is broken after a predetermined period elapses in a state where the stent 100 indwells. In this manner, the connection structure 61 can oscillate (is movable).
As illustrated in
When the stent 100 is configured to serve as a balloon expandable stent, a known metal may be appropriately selected for a material of the stent body 110. The metal for the stent body 110 may be stainless steel which is a non-biodegradable metal material, a cobalt-based alloy such as a cobalt-chromium alloy, or an elastic metal such as a platinum-chromium alloy. On the other hand, when the stent 100 is configured to serve as a self-expandable stent, a known super-elastic alloy may be appropriately selected.
The connection member 71 is formed of a biodegradable material such as a biodegradable polymer material or a biodegradable metal material. The biodegradable polymer material is preferably a biodegradable synthetic polymer material such as polylactic acid, polyglycolic acid, lactic acid-glycolic acid copolymer, polycaprolactone, lactic acid-caprolactone copolymer, glycolic acid-caprolactone copolymer, and poly-γ-glutamic acid, or a biodegradable natural polymer material such as cellulose and collagen. Magnesium or zinc may, for example, be used for the biodegradable metal material.
A drug coated layer containing a drug can be formed in the stent 100. For example, the drug coated layer can be disposed on an entire outer surface on a side coming into contact with the lumen of the living body or on a portion of the outer surface. The drug coated layer may contain a drug carrier for carrying the drug or may be configured to contain only the drug without the drug carrier. For example, a thickness of the drug coated layer is 1 to 300 μm, and preferably 3 to 30 μm.
Examples of the drug contained in the drug coated layer are anticancer drugs, immunosuppressive drugs, antibiotics, anti-rheumatic drugs, anti-thrombotic drugs, HMG-CoA reductase inhibitors, insulin resistance improving drugs, ACE inhibitors, calcium antagonists, anti-hyperlipidemic drugs, integrin inhibitors, anti-allergic drugs, anti-oxidants, GP IIb/IIIa antagonists, retinoids, flavonoids, carotenoids, lipid improving drugs, DNA synthesis inhibitors, tyrosine kinase inhibitors, antiplatelet drugs, anti-inflammatory drugs, biologically-derived materials, interferon, and nitric oxide production-promoting substances.
When the stent 100 is configured to treat a stenosed site in the blood vessel, it is preferable that the drug coated layer contains paclitaxel, docetaxel, sirolimus, and/or everolimus. It is more preferable that the drug coated layer contains sirolimus or paclitaxel.
It is preferable that the drug carrier is polymer material, and more preferably a biodegradable polymer material which degrades inside a living body. After the stent 100 is caused to indwell in the lumen of the living body, the biodegradable polymer material carrying the drug degrades. The drug is released to restrain restenosis at the stent indwelling site. It is possible to use the same materials as those discussed above regarding the connection member 71 for the biodegradable polymer material.
As described above, the stent body 110 includes a plurality of helical portions 111 (in which the strut 111a is formed in a helical shape along the axial direction Z) and an annular portion 112 disposed between the helical portions 111 adjacent to each other in the axial direction Z. The strut 112a is formed in an annular shape along the circumferential direction S to form the annular portion 112. According to this configuration, the annular portion 112 (in which one end side and the other end side are endlessly connected to each other) is more likely to maintain its shape in the radial direction K than the helical portion 111 (in which one end side and the other end side are separated from each other). Therefore, after the stent 100 expands and the diameter of the stent body 110 increases, the annular portion 112 can restrain the helical portion 111 from deforming when the stent body 110 attempts to reduce the diameter to restore the original shape. That is, the stent 100 can restrain a contraction force (diameter reduction force) generated due to the deformation with the diameter expansion, and it is possible to considerably decrease a recoil rate.
The stent body 110 further has the annular portions 112 (112P and 112R) on at least one side of the proximal side 110b and the distal side 110d along the axial direction Z. Accordingly, at least one side of the proximal side 110b and the distal side 110d can also help restrain the deformation of the helical portion 111 which attempts to reduce the diameter of the stent body 110. Therefore, it is possible to further decrease the recoil rate of the stent 100.
At least one annular portion 112 (112Q) of the stent body 110 is disposed in a central portion 110c between the proximal portion 110a and the distal portion 110e in the axial direction Z. The at least one annular portion 112Q helps make it possible to sufficiently restrain the deformation of the central portion 110c which is most likely to be distorted within a range along the axial direction Z of the stent body 110. Therefore, it is possible to effectively decrease the recoil rate of the stent 100.
The stent 100 further has the connection portion 60 that connects at least one location of windings of the helical portion 111 in the axial direction Z of the stent body 110. The connection portion 60 decreases the connecting force after a predetermined period elapses when the stent body 110 indwells in the living body. Here, the helical portion 111 is constrained along the axial direction Z by the connection portion 60. Accordingly, when the stent body 110 expands the diameter, the struts 111a extend outward in the radial direction of the struts 111a while the interval L1 between the struts 111a with respect to the axial direction Z remains constant. That is, the helical portion 111 is constrained along the axial direction Z by the connection portion 60. The helical portion 111 is thus changed and twisted so that the helical angle θ1 of the struts 111a becomes larger. As a result, the helical portion 111 attempts to be untwisted by reducing the diameter. Even according to the configuration in which the stent 100 has the connection portion 60, the annular portion 112 can sufficiently restrain the deformation of the helical portion 111. Therefore, it is possible to effectively decrease the recoil rate.
The connection portion 60 has the connection member 71 configured to include the biodegradable material. Accordingly, it is possible to decrease the connecting force as time elapses in accordance with the degradation of the biodegradable material. Therefore, it is possible to achieve satisfactory followability inside the lumen.
The annular portions 112 are formed in an annular shape along the circumferential direction S (i.e., the annular portions 112 are non-helical) while alternately protruding and curving the strut 112a toward the proximal side 110b and the distal side 110d along the axial direction Z (i.e., the annular portions 112 have a wavy-shape in the circumferential direction S as shown in
A stent 300 according to a modification example will be described with reference to
The stent 300 has a configuration different from that of the stent 100 according to the embodiment discussed above in that the arrangement patterns of the helical shapes of adjacent helical portions 311 are different from each other (e.g., the patterns created by the helical shapes of adjacent helical portions 311 are different from one another in the circumferential and/or axial directions). In the modification example according to the embodiment illustrated in
Helical portions 311 (311M and 311N) adjacent to each other across the annular portion 112 have different arrangement patterns of the helical shapes along the circumferential direction S. The helical portion 311M is spaced along the axial direction Z from the helical portion 311N. The positions of struts 311a of the helical portion 311M and are shifted from the struts 311a of the adjacent helical portion 311N by an angle corresponding to a half pitch along the circumferential direction S. The helical portions 311 (311M and 311N) adjacent to each other across the annular portion 112 may have different shapes. When the relative dimensions or the shapes of the curved portions 48 are different from each other, the helical portions 311 (311M and 311N) possess different flexibility characteristics.
The helical portions 311 (311M and 311N) adjacent to each other across the annular portion 112 have mutually different arrangement patterns of the respective helical shapes as discussed above. Accordingly, the annular portions 112 that have different flexibility characteristics restrain mutual contraction forces (diameter reduction forces). Therefore, it is possible to effectively decrease the recoil rate.
The helical portions 311 (311M and 311N) have different arrangement patterns of the helical shapes along the circumferential direction S. Accordingly, the mutual contraction forces (diameter reduction forces) are applied to the respective annular portions 112 of the stent 100 so as to be restrained along the circumferential direction S. It is thus possible to considerably decrease the recoil rate. In particular, for example, when the stent 300 is caused to indwell the blood vessel located in the vicinity of the heart, the recoil subsequently occurring due to the blood vessel twisting and deforming in response to the pulsation of the heart can be relieved along the circumferential direction S.
The stent disclosed in this application has been described above in reference to the embodiments illustrated in
For example, at least one or more annular portions of the stent may be disposed at a position separated from (spaced apart from) the end point of the distal portion and the proximal portion in a region between the distal portion and the proximal portion along the axial direction Z. For example, the stent may include four or more annular portions so that two annular portions are respectively disposed at each of the ends of the distal portion and the proximal portion along the axial direction Z and two annular portions are disposed therebetween. In addition, the two helical portions adjacent to one another on either side of a central annular portion may possess a helical direction (winding direction) that are opposite one another (e.g., the two helical portions may be wound in opposite directions).
The stent may be a balloon expandable stent which can be caused to indwell the living body in such a way that a balloon catheter is used as a delivery catheter and the stent is deformed with diameter expansion of the dilated (expanded) balloon. Alternatively, the stent may be a self-expandable stent which indwells in the living body by using a catheter having a slidable cover sheath as a delivery catheter. The stent itself is deformed with diameter expansion (i.e., self-expands radially outwardly) after the stent is released from the sheath.
The base material of the stent is not limited to those which are configured to include the metal material. As long as the stent is configured to include a material which can be elastically deformed so as to generate the recoil, any base material may be employed. For example, the stent body may be configured to include a biodegradable polymer material.
In addition, a structure, dimension, and shape of each element of the stent disclosed in this application can be appropriately changed. For example, the use of the additional member described in an embodiment can be appropriately omitted, or other additional members which are not particularly described in the embodiment can be appropriately used.
The detailed description above describes a stent. The invention is not limited, however, to the precise embodiments and variations described. Various changes, modifications and equivalents can be effected by one skilled in the art without departing from the spirit and scope of the invention as defined in the accompanying claims. It is expressly intended that all such changes, modifications and equivalents which fall within the scope of the claims are embraced by the claims.
Number | Date | Country | Kind |
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2014-261064 | Dec 2014 | JP | national |
Number | Date | Country | |
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Parent | PCT/JP2015/081654 | Nov 2015 | US |
Child | 15627576 | US |